Neuropathology 1: CVD

Question 1

name the 3 types of glial cell

Answer 1

astrocytes - most prevalent
oligodendrocytes
ependymal cells

Question 2

ependymal cells line..

Answer 2

the ventricular system

Question 3

what is the pathological cellular response seen in stroke?

Answer 3

rapid necrosis with sudden acute functional failure

Question 4

what kind of neuronal damage occurs as a result of hypoxia?

Answer 4

acute neuronal injury with irreversible shrinking and angulation of nuclei, loss of the nucleolus and a RED cytoplasm

Question 5

when does acute neuronal injury occur in relation to the time of injury

Answer 5

12-24 hours after injury

Question 6

name the axonal reaction to injury?

Answer 6

increased protein synthesis

degeneration of myelin sheath and axons distal to injury

Question 7

what does chronic degeneration of a neuron look like?

Answer 7

shrunken, angulated and lost neurons
small dark nuclei
neuronal tissue replaced by reactive gliosis

Question 8

small dark nuclei are an example of what damage?

Answer 8

chronic damage

Question 9

what are inclusions? what are they common in?

Answer 9

subcellular alterations common in neurodegenerative conditions eg alzheimers and in aging

Question 10

oligodendrocytes are sensitive to ___ damage

Answer 10

oxidative

Question 11

damage to the myelin sheath poses what risks?

Answer 11

conduction reduced

axons exposed to injury

Question 12

damage to what cells is a feature of demyelinating disorders

Answer 12

oligodendrocytes

Question 13

star shaped cells with multipolar cytoplasmic processes describe….

Answer 13

astrocytes

Question 14

what do the cytoplasmic processes of astrocytes do?

Answer 14

envelop synaptic plates

wrap around vessels and capillaries of the brain

Question 15

what cells are responsible for reabsorbing and recycling glutamate?

Answer 15

astrocytes

Question 16

what pathological process is the main indicator of CNS injury?

Answer 16

gliosis

Question 17

describe gliosis

Answer 17

astrocyte hyperplasia and hypertrophy
prominent nucleolus
small dark nuclei

Question 18

describe the role of M1 microglia

Answer 18

anti-inflammatory, phagocytic, for acute injury

Question 19

describe the role of M2 microglia

Answer 19

pro-inflammatory, for chronic injury

Question 20

which type of microglia is for chronic injury

Answer 20

M2

Question 21

what happens to microglia when theyre injured?

Answer 21

they proliferate, are recruited via inflammatory mediators and form aggregates around necrotic tissue

Question 22

most common cause of nervous system injury?

Answer 22

hypoxia

Question 23

the brain consumes __ % of the body’s total oxygen

Answer 23

20

Question 24

describe the process of excitotoxicity

Answer 24

energy failure in the cell results in degradation of the mP -> glutamate released but not reabsorbed well -> severe excitation -> Ca excess

Question 25

excess Ca as a result of excitotoxicity has what consequences?

Answer 25

oxidative stress
apoptisis
mitochondrial dysfunction
protease activation

Question 26

what happens in cytotoxic oedema? what can it lead to?

Answer 26

excess Na and Cl in the cell cause water to move into the cells across the BBB causing ionic oedema

Question 27

vasogenic oedema occurs in what brain pathologies?

Answer 27

trauma, tumours, inflammation

encephalopathy

Question 28

the brain receives __% of the cardiac output

Answer 28

15

Question 29

global hypoxic ischaemic damage can occur in the context of…

Answer 29

generalised reduction in perfusion/oxygenation
cardiac arrest
severe hypotension

Question 30

focal hypoxic ischaemic damage can occur in the context of…

Answer 30

vascular obstruction

Question 31

what parts of the brain are more susceptible to ischaemic damage?

Answer 31

areas between arterial territories

Question 32

neurons are more sensitive than glial cells to hypoxic ischaemic damage T or F

Answer 32

T, especially purkinje cells in the cerebellum

Question 33

what kind of infarctive stroke is most common?

Answer 33

thrombotic

Question 34

most common area for a thrombotic infarctive stroke

Answer 34

middle cerebral artery

Question 35

where do cardioemboli tend to arise from?

Answer 35

internal carotids
aorta
heart

Question 36

after 12-24hrs of cerebral infarction what does the brain look like microscopically?

Answer 36

red neurons, oedema

Question 37

what becomes the predominant cell type -14 days after a cerebral infarction?

Answer 37

microglia

Question 38

when does gliosis begin after a cerebral infarction

Answer 38

1 week

Question 39

when does a gliotic scar appear after a cerebral infarction

Answer 39

after a few weeks

Question 40

clinical presentation of a middle cerebral artery occlusion

Answer 40

weakness in contralateral face and arm

Question 41

what is arteriolosclerosis

Answer 41

thicker, stiff, weaker arterioles

Question 42

lacunar infarcts occur from occlusion of….

Answer 42

small penerating arteries

Question 43

clinical presentation of hypertensive encephalopathy?

Answer 43

severely hypertensive

symptoms of raised ICP

Question 44

pathological findings of hypertensive encephalopathy?

Answer 44

arteriolar fibrinoid necrosis
petechiae
tentorial and tonsillar herniation
global cerebral oedema

Question 45

what does amyloid do to BVs

Answer 45

thins their walls making them more likely to rupture

Question 46

most likely area for an intracerebral haemorrhage

Answer 46

in basal ganglia

Question 47

most common cause of subarachnoid haemorrhage?

Answer 47

berry aneurysm rupture

Question 48

most common area of berry aneurysms?

Answer 48

around arterial bifurcations arising from the cirle of willis
in territory of internal carotid

Question 49

complications of subarachnoid haemorrhage

Answer 49

infarcts in brain parenchyma
intracerebral haematomas
hydrocephalus